Quick Answer
Pancreatitis is inflammation of the pancreas. Acute pancreatitis is sudden, severe and usually due to gallstones or alcohol. Chronic pancreatitis develops over years, causing pain, malabsorption and diabetes. Dr. Anando Sengupta manages both with intensive medical care, ERCP for stones, EUS for pseudocyst drainage, and structured pain & nutrition therapy at Fortis Shalimar Bagh.
Acute pancreatitis
Symptoms
- Sudden severe upper abdominal pain, typically radiating to the back
- Pain often worsens after meals or alcohol
- Nausea, persistent vomiting
- Fever, rapid pulse
- Abdominal distension
- In severe cases: shock, breathlessness, kidney injury, confusion
Causes
- Gallstones (most common in Indian women)
- Alcohol (most common in Indian men)
- Hypertriglyceridaemia (> 1000 mg/dL)
- Post-ERCP
- Trauma
- Drugs (azathioprine, valproate, GLP-1 agonists in rare cases)
- Autoimmune (IgG4-related)
- Idiopathic
Treatment
- Hospital admission with intravenous fluids (first 24–48 hours are critical)
- Pain control with paracetamol and opioids; avoid NSAIDs in dehydration
- Early oral feeding once tolerated
- ERCP within 24–72 hours for cholangitis or persistent biliary obstruction
- Cholecystectomy during the same admission for gallstone pancreatitis
- Necrosectomy / EUS-guided drainage at 4–6 weeks for symptomatic walled-off necrosis
Chronic pancreatitis
Symptoms
- Recurrent or persistent upper abdominal pain
- Steatorrhea — oily, foul-smelling, floating stools
- Significant weight loss despite eating
- New-onset diabetes (type 3c)
- Fat-soluble vitamin deficiency (A, D, E, K)
Causes
- Alcohol (long-standing)
- Tropical pancreatitis (Indian sub-continent specific)
- Genetic mutations (PRSS1, SPINK1, CFTR)
- Recurrent acute pancreatitis
- Autoimmune pancreatitis
- Pancreatic duct strictures or stones
Treatment
- Strict alcohol abstinence and smoking cessation
- Pancreatic enzyme replacement therapy (PERT, e.g. Creon) with each meal
- Pain management — analgesics, neuromodulators, EUS-guided coeliac plexus block
- ERCP for pancreatic duct stones & strictures, ± stent
- ESWL for large pancreatic stones
- Surgery (Frey procedure, Puestow, total pancreatectomy with islet autotransplant) for refractory pain
- Diabetes management with insulin (sulfonylureas often unsuitable)
- Fat-soluble vitamin and trace mineral replacement
- Cancer surveillance — long-standing chronic pancreatitis raises pancreatic cancer risk
Frequently Asked Questions
In India the leading causes are gallstones (especially in women), alcohol (especially in men), high triglycerides, post-ERCP pancreatitis, drug-induced, autoimmune pancreatitis, and idiopathic. Tropical chronic pancreatitis is a regional Indian variant.
Diagnosis requires 2 of 3: characteristic abdominal pain, serum amylase/lipase > 3x upper limit, or imaging features. Severity is graded clinically (Atlanta criteria) and on CT (CTSI score).
Mild cases recover in 5–7 days. Moderate-severe cases with necrosis or organ failure may require 2–6 weeks of hospital care, often including drainage of pseudocysts or necrosis 4–6 weeks later.
Chronic pancreatitis is irreversible, but pain, malabsorption and diabetes can be controlled with enzyme replacement, ERCP-guided stone clearance, EUS-guided coeliac plexus block, and surgery in selected cases.
Chronic inflammation damages pancreatic acinar cells leading to enzyme deficiency. Without enough lipase, fat is not absorbed (steatorrhea) and patients lose weight despite eating. Pancreatic enzyme replacement therapy corrects this.
Small stones are removed by ERCP with stone extraction, sphincterotomy and stenting. Larger stones may need extracorporeal shock-wave lithotripsy (ESWL) or surgical drainage in resistant cases.
Yes. Dr. Anando Sengupta consults at North Delhi Nursing Home, Ashok Vihar Phase II (Mon–Sat, 5:30–7:30 PM) — within easy reach of Model Town (3 km), GTB Nagar, Mukherjee Nagar, Wazirpur and Shastri Nagar. Morning slots and procedures (endoscopy, colonoscopy, ERCP, EUS) are at Fortis Hospital, Shalimar Bagh (~3 km from Pitampura, with cashless insurance on all major panels). Both clinics serve patients from across North Delhi.
